Retrospective population-based cohort study on the risk of cardiovascular disease among oesophageal cancer survivors

Introduction: There is little data on the occurrence of cardiovascular disease (CVD) in oesophageal cancer (OC) survivors. Risk of CVD was investigated as a composite of myocardial infarction (MI), atrial fibrillation (AF), heart failure (HF), and ischaemic stroke (IS), as well as CVD-specific death among OC survivors after surgery. Methods: A population-based retrospective cohort study was performed using the Korean National Health Insurance Service database (2009–2022), including patients who underwent surgery for OC (n = 3996) and 1:3 propensity score–matched non-cancer controls (n = 11 988). Results: A total of 3996 OC survivors and 11 988 non-cancer controls were included in this study. Among OC survivors and controls, 492 and 1599 incident CVD cases and 33 and 305 CVD-specific deaths were observed respectively. OC survivors showed a higher risk of CVD (cause-specific hazard ratio (csHR) 1.42, 95% c.i. 1.28 to 1.57) than controls, and patients who underwent chemoradiotherapy plus surgery were at the highest risk. The increased risk was most prominent within the first year after surgery (csHR 3.00, 95% c.i. 2.35 to 3.85), but persisted thereafter (csHR 1.23, 95% c.i. 1.10 to 1.38 at 1-year lag; csHR 1.23, 95% c.i. 1.08 to 1.40 at 3-year lag; csHR 1.34, 95% c.i. 1.14 to 1.57 at 5-year lag). This pattern was evident for MI and AF, but not for HF, IS, or CVD-specific death. Discussion: There is an increased risk of CVD in OC survivors compared to controls. The risk of CVD varied by the outcome, treatment, and duration after surgery.